Internal Adhesions

I recently completed my certification in Equine Osteopathy and one of the most valuable aspects of this course has been the emphasis on internal causes of external problems. In other words, many of the problems we see externally in the spine and musculoskeletal system actually originate from problems with the internal organs and the connective tissues that surround them.

In fact, Janek Vluggen, my osteopathic instructor, estimates that fully 80% of the external problems we see in horses are caused by these internal problems. To be more specific, problems with internal organs commonly lead to adhesions, which affect the connective tissues, and show up as external symptoms. Thus it can be costly and ultimately ineffective to have your equine chiropractor constantly readjust the same problem areas on your horse if the source of the problem is internal adhesions.

Not surprisingly, osteopathy puts a strong emphasis on releasing these adhesions. An adhesion is the abnormal union of separate tissue surfaces by new fibrous tissue resulting from an inflammatory process. In other words, internal tissues are connected in ways they were never meant to be connected. Many of us have seen a common process by which adhesions are formed: scars from skin wounds often adhere to the underlying connective tissues. If it is large enough, a scar can affect the mobility of a joint. In fact, even small scars can interfere with blood vessels, nerves, and acupuncture meridians. A scar that interferes in this way is called a "toxic scar," and veterinarians often treat it by injecting local anesthetic and anti-inflammatory agents around and under the scar to free it from adjacent tissues.

Most of us are well aware of the negative effects of scars so we are careful to treat wounds carefully to minimize scarring. Careful treatment does reduce the probability of external scarring, but what about the inflammation and adhesions that might be affecting our horses' internal organs?

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Adhesions Around the Liver and Stomach

Stomach ulcers occur on the inside of the stomach but the inflammation from an ulcer can affect the outer walls of the stomach as well. Because the stomach is located near the liver, diaphragm, and pancreas, these organs can also be impacted by the stomach ulcer. For instance, when adhesions form in this area the pancreatic ducts can become constricted so that digestive enzymes are less able to reach the small intestine. Inflammation and adhesions around the liver have a similar effect on the bile ducts, so that less bile is available to digest fat in the small intestine. For horses on high protein and high fat diets, reduced levels of pancreatic enzymes and bile can lead to serious digestive issues. Food is not properly digested in the upper small intestine so it passes into the lower small intestine and large intestine in basically undigested form. This undigested food upsets the bacterial balance in these two areas, which then interferes with proper fiber digestion. Eventually, this whole process can lead to gas, pain, and colic. Clearly, preventing adhesions and inflammation in these three organs (stomach, liver, and pancreas) is important and can save both you and your horse from a lot of stress.

Stomach Ulcers

Because stomach ulcers can so easily cause adhesions, it's important to take preventative measures. Yet, even with high-fiber diets and natural lifestyles, stomach ulcers are quite common in performance horses. Trailering horses to and from events has proven to be a major form of stress that can lead to ulcers, and yet it is impossible to compete without doing some hauling. To prevent ulcers, give horses who are frequently hauled a natural ulcer prevention product such as Succeed or Stomach Soother. Another option is to feed aloe vera and slippery elm, but these products are more difficult to use if your horse goes off his feed. For the horse who competes occasionally on the weekends, start feeding Stomach Soother the day before you haul to the event and continue through the day you return home.

All of these products protect, soothe, and support the healing of the digestive tract. Antacids and acid blockers should not be used long-term because they can potentially upset the normal pH of the gut and interfere with proper digestion.

Liver Stress

Toxins such as non-steroidal anti-inflammatory drugs (NSAIDs), vaccines, dewormers, insecticides, and antibiotics all stress the liver. Corticosteroids, either given to treat disease or produced naturally by the body during stress, also negatively affect the liver. To heal the liver, the herb milk thistle is ideal. Buy milk thistle seeds and grind a week's worth at a time in a coffee grinder. Feed 1 tablespoon daily for two to three weeks. Also consider feeding coenzyme Q10 and wheat sprouts to support the liver.

Because the inflammation and swelling of the liver can cause symptoms similar to those of stomach ulcers, you might have difficulty figuring out which organ is inflamed. Fortunately, because of the nerve connections around the stomach and liver, we can sometimes use small differences in the symptom patterns to locate the problem area. A horse with a stomach ulcer is likely to be stiff in the left shoulder while a horse with liver inflammation and adhesions will tend toward a stiff right shoulder.

Inflamed or Restricted Pancreas

The pancreas produces both digestive enzymes and insulin. When your horse is under stress, his body needs extra insulin to convert glycogen to glucose. If the pancreas is inflamed or restricted by adhesions, it will not be able to properly support digestion or glucose metabolism. If blood work indicates that the pancreas is not able to function, you may need to give additional herbs to support these processes. For instance, the EMS solution is an ideal herbal formula for this situation, and can be ordered from http://www.forloveofthehorse.com.

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Preventing Adhesions

The diet of every competition horse should include probiotics, digestive enzymes, blue-green algae, and a natural antioxidant, such as Noni or Xango juice. In addition, horses who are regularly hauled should be given some kind of natural protective agent to prevent stomach ulcers. Limiting stress, providing free access to hay, and giving plenty of turnout on grass are also essential. Finally, because the liver, stomach, and pancreas all lie under and adjacent to the diaphragm, it is important to keep your horse's ribs moving freely to prevent adhesions. Bending and suppling exercise will help to keep these internal organs mobile.